国家基本公共卫生服务乡村两级职责分工研究  

Responsibility division for health service institutions at township and village level in national basic public health service project

作　　者：方海清[1,2] 周东华[3] 王曼丽[1,2] 付航[1,2] 唐尚锋 冯占春[1,2] 

机构地区：[1]华中科技大学医药卫生管理学院,湖北武汉430030 [2]湖北省人文社科重点研究基地-农村健康服务研究中心 [3]武汉商学院体育与马术学院

出　　处：《中国公共卫生》2015年第4期405-408,共4页Chinese Journal of Public Health

基　　金：国家自然科学基金(71273097)

摘　　要：目的探索乡村两级卫生机构在国家基本公共卫生服务项目中的职责分工明细。方法运用文献法、专家咨询法和逻辑测验法制定调查问卷,对中西部四省10个乡镇卫生院和22个村卫生室进行调查,并对数据进行分析。结果 41个国家基本公共卫生服务项目二级项目指标中,乡村两级存在分歧的有24个,占58.53%;乡村承担差值均>0,其中≥20%达70.73%;乡级认为项目总体承担比例为乡级0.72,村级0.28,所有项目承担比例均≥50%;而村级认为比例为乡级0.43,村级0.57,有29个项目承担比例≥50%,占70.73%;探索结果显示承担比例为乡级0.61,村级0.39;乡级主承担项目,村级协助完成项目。结论乡村两级对项目承担比例分歧较大,一级指标缺乏可操作性,应该将职责分工细化至二级指标,二级指标更加能够指导乡村协作开展基本公共卫生服务。Objective To explore detailed responsibility division for health service institutions at the tw o-level of tow nship and village in national basic public health service. Methods Literature review,expert consultation,and questionnaire survey were adopted in the study and logic test was used in data analysis. Totally 10 tow nship hospitals and 22 village clinics in 4 provinces in central western region of China were included in the study. Results Among the 41 secondary project indicators of national basic public health service,24（58. 53%） were recognized differently for the institutions at tow nship and village level. The average difference value in the ratio of responsibility division for all the 41 secondary indicators perceived by the medical staff in tow nship institutions versus those in village clinics was greater than zero and the difference values for 21 indicators（70. 73%） were not less than 0. 2. The responsibility division ratio perceived by the staff in tow nship medical institutions for overall project at tow nship and village level was 0. 72 and 0. 28,whereas that perceived by the staff in village clinics was 0. 43 and 0. 57,respectively. The results of this exploratory study suggested that national basic public health service project should be undertaken mainly by tow nship medical institutions and assisted by village clinics with the responsibility division of 0. 61 and 0. 39. Conclusion There is an obvious difference in responsibility division for national basic public health service project perceived by the staff in tow nship hospitals and village clinics. The first-level indicators of the project are lack of maneuverability and should be refined into secondary indicators for the assistant performance of village clinics in the implementation of the project.

关 键 词：基本公共卫生服务 乡村两级 职责分工 

分 类 号：R193[医药卫生—卫生事业管理]